Sleep Problems in Military Veterans with a History of Blast Concussion

New research on military veterans has found that concussions related to blast explosives lead to hormonal changes and problems like fatigue, depression, sleep disturbances, and poor quality of life. This new research will be presented at the Endocrine Society’s 98th annual meeting to discuss the 41 male veterans that were studied. These participates were deployed to either Afghanistan or Iraq.

The study’s lead researcher from the Veterans Affairs Puget Sound Health Care System in Seattle, Dr. Charles Wilkinson, states that the hormone deficiencies that were found could be successfully treated with replacement therapy if they are diagnosed correctly. These deficiencies, he states, can mimic some of the symptoms present in posttraumatic stress disorder, a common diagnosis among war veterans.

The goal of this research, Dr. Wilkinson states, is to raise awareness of the hormonal imbalance in light of the prevalence of head injuries that have occurred as a result of improvised explosive devices in modern-day warfare. Mild traumatic brain injury (mTBI), or concussion, accounts for 80% of all TBI diagnoses in United States service members, according to estimates given by the government in 2010.

It is noted by the research team that there is surprisingly limited data on the prevalence of hormonal deficiencies in military veterans, but that they account for 25-50% of cases involving brain injuries in civilians.

In this study, which was funded by the Department of Veterans Affairs, researchers reviewed blood samples from 41 male veterans: 27 veterans had one or more concussions from blast explosives within the last year and 14 men were previously deployed and had no history of exposure to blasts or a history of concussions. Eleven hormones in the blood were measured, which were all related to the pituitary systems. The pituitary gland is located at the base of the brain and called the “master gland” because it generally interacts or affects every part of the body.

Findings showed that 44%, or 12 people, from the veterans who sustained concussions from the blast explosives had imbalanced or irregular hormone levels. This indicated an underactive or malfunctioning pituitary gland, referred to as hypopituitarism. Furthermore, only 7% (one person) from the group of 14 without any blast injuries or concussions had abnormal levels.

In an attempt to relate symptoms with specific hormonal problems, the scientists gave tests and questionnaires about fatigue, depression, sleep, memory, social isolation, quality of life, and PTSD. Dr. Wilkinson said that, surprisingly, every test showed that the mTBI participants and those with hypopituitarism had more accentuated problems than those who did not show any problems with their hormones but still had mTBI, as well as those without either hormonal imbalance or concussion history.

The veterans who had both the hormonal imbalance and mTBI had significantly decreased quality of sleep, more severe depression, and a greater amount of fatigue than the mTBI participants with no hormonal irregularities.

Dr. Wilkinson does note that the value of hormonal screening in those who have had concussions and chronic symptoms is debatable. However, if the hormonal irregularity as a possibility in these veterans is not considered, then adequate treatment may not be possible.